HomeMy WebLinkAboutDriveway Street Cut Permit 9 Arnold Way Permit No. 2467 Town of South Windsor, CT
Date 07/16/1998 Street Excavation Permit
Expiration Date 07/16/1999
Descrip:
Applicant ! Location
8 a, " ��
Name BOUTIN & SONS �f1C L WAY
Addr. 121 WINDSORVILLE ROA ` �a '° � ,
BROAD BROOK CT 0601,E war � p RIVEWAY
Phone (860)623-2526
Applicant agrees td �Furfi 4" � he e r i?Pfi or the amount of bond
required and to reimbcare 'bwirht � fi any expenses
incurred by the Town far mat�nn� ►r pair' connection with this
permit and that app 1 i oaf 1 ' ate anda; fi V, tfi de by the rules and
regulations for permit as .. .1 k �
� to9th Windsor's Street
Cut Permit Manual .
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* * .PERMIT TO ,B1 �� � !� � L TIMES.
Issued by -
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Date Completed Inspected By
31*7
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm r' Phone No. tiJ "
Address of Firm '
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No. cuts
Amt.of Deposit S by
()Cash() Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee S
Amt. Due Town S
Applic t is responsible or contacting
the P lice Dept. and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO RQMSURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOOT WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: C G
Title: D.L.#
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES